Health Care Spending Targeted By American College Of Physicians Guidelines

A breast cancer patient is helped by a technician after a CT scan at the UCSF Comprehensive Cancer Center

A proposition from a major physicians group is catching flak for evoking the specter of "rationing" medical care for those in need. But the group says its proposal could save hundreds of billions of dollars and improve patients' health.

The American College of Physicians this year introduced new guidelines that could reign in the costs of medical tests. The idea is to help doctors better target individual patients' needs--instead of over-prescribing tests that could possibly even harm patients. The shift could save a lot of money, time, and hassle.

Steven Weinberger, the organization's chief executive officer, told Reuters that unnecessary medical tests waste as much as $250 billion every year. "There's an overuse of imaging studies, CT scans for lung disease, overuse of routine electrocardiograms and other cardiac tests such as stress testing," Weinberger told Reuters. A 2009 Thomson Reuters analysis estimated total waste in the U.S. health care system to be as high as $850 billion a year.

The physicians' society, which has about 132,000 members, aims to tackle one of the stickiest problems in the U.S. health care system: how to trim costs without reducing the quality of medical care. The American College of Physicians also is endorsing the argument that over-testing of patients not only creates unnecessary spending, it also subjects people to risks and anxiety and may lead to treatments they could have gone without.

The medical society published its new ethics guidelines last month in the Annals of Internal Medicine and identified 37 types of cases when physicians should think twice before ordering tests that may be wasteful and possibly harmful to the patients, Reuters reported.

The American College of Physicians' new guidelines have generated controversy that reflects the ongoing debate about how much the U.S. should spend on health care and how we should allocate those resources. In particular, critics have seized on the use of the word "parsimonious" in the document.

Physicians have a responsibility to practice effective and efficient health care and to use health care resources responsibly. Parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available.

This is worrisome to those who fear medical care will be denied to people in need because of cost or because they are too old or too sick. "The word itself carries a connotation that is going to give people pause if it’s a precursor to rationing," Rep. Michael Burgess (R-Texas), a physician who opposed Obama's health law along with all other congressional Republicans, told Kaiser Health News.

Comments

[Lisa Cara]

04:28 PM on 02/25/2012

As long as the Profit is the point of what you do, you will never see anything other than ways to increase your share, thus feeding the parasitic cycle. Profit is the devil leading us all to damnation as a species.

[Res Ipsa Loquitor]

05:10 AM on 04/16/2012

Since doctors write all orders for tests and treatments you need to look to them about the excessive ineffective and even harmful test and care. "Doctors tend to order what benefits them."

Too many people connected to providing health care are more interested in their profit that anything else.

[hoosierdaddyno1]

01:39 PM on 02/25/2012

Lets see?
Who is behind the writing of this article?
Yea the health insurance companies , that's who will save the most ,not the peoples care!

[Res Ipsa Loquitor]

05:17 AM on 04/16/2012

You are delusional. There is nothing in the article even mentioning insurers or linking to them in any way. This is reporting on what a group representing a major physicians organization recommend. What they aren't stressing is that much of the over testing and treatment is frequently harmful to patients.

One big problem raising your costs is the ignorance and greed of patients. Too many equate more treatments with better care, more expensive treatments and drugs are better, and that newer is better. All of these are untrue in a lot of common situations of your actual health CARE.

[mungomunro]

11:02 AM on 02/25/2012

Everything went to heck when the healthcare industry started calling us, health consumer, health care consumer or client

[nothingchanges]

09:37 AM on 02/25/2012

Lets see.

We make a profit of $5.00 on every x-ray.

and a profit of $265 on every CT.

Why would that possibly influence which imaging process to use?

(Not to mention that a CT exposes it's recipient up to 600 times the amount of radiation as a single x-ray)

Profit over people, it's the American way.............and it's growing, like a cancer.

[Res Ipsa Loquitor]

05:26 AM on 04/16/2012

Bingo! You've got it.

But a lot of ignorant people demand the more expensive test or treatment I think in part for a status symbol.

[pup sydney]

11:58 PM on 02/24/2012

Have you ever read of a study on cheap drugs? No the drugs they test add 34 days of painful life to a terminal cancer patients and cost all of us billions while simple effective remedies are never tested because drug companies do not make money out of cheap drugs. If the gvnmt does not do those studies who will? Santorum or Palin? Oh Almighty God give people an eye and a brain!. Wake up people a bit of socialism is necessary or we end in total poverty.

[h23154]

04:38 PM on 02/24/2012

Health care is already rationed because it is a simple fact that your insurer, if you have one, decides what you can and can not get. And they deny lots of doctor recommendations. I know of a bone surgeon who specialized in certain cancer treatments who was routinely told by insurers that they would not approve surgery because the odds of it being a cure were to slim. I don;t know what happens now but not long ago bariatric surgery was deemed "experimental" and rarely, if ever, approved by insurers. Inthe cancer case, they approved cheaper chemo that would not work, but let the patent think he was being cared for. The flip side of that is peopls who get all kinds of extravagent and costly treatments that won't do a meaningful thing for them - or for an aged parent, for example - because more pliable insurers are willing to approve them. At some point in many peoples' lives tough decisions have to be made and all we are really debating is who gets to make them. It's a good argument for people making sure they have living wills or advance health care directives and unless you really trust someone else, do not appoint an agent who can change what you decided for yourself.

[NevaforLeadership]

02:33 PM on 02/24/2012

Test after test and checkup after checkup were reinforced by greedy doctors and gullible patients. Now they understand they were reinforcing the deterioration of the whole healthcare system.

Better late than never to change.

The four pillars of healthcare should be good nutrition, exercise, education and accountability.

[TeeLolly]

12:05 PM on 02/24/2012

Of course, none of the savings would be passed on to patients or even to doctors--the health insurers would never lower premiums or raise the amounts they pay to doctors based on any savings from eliminating costly but unnecessary procedures--their top execs would pocket every penny. 

(This gives a whole new meaning to the adage, "a penny saved is a penny earned" ...)

[Linda Dines]

03:19 PM on 04/04/2012

It helps if people proactively participate in keeping themselves safe, well fed and get the available vaccines, when offered.

[Karelh]

10:27 PM on 02/23/2012

With our current, broken system, dr.'s probably over prescribe test for fear of legal action against them but also, for profit, it's a pretty easy gravy train to request a test and then bill a 3rd party insurance company. The whole thing is broken and just keeps feeding upon itself, there is no one simple fix, but for sure this model does not work.

[h23154]

04:44 PM on 02/24/2012

The fix is getting away from a fee for service model. The actual cost of the medical liability system relative to the costs of health care is about 2.4%. It's a lot of dollars but even if it were completely eliminated by making doctors immune from suit for their own negligence - which no one in his right mind would suggest - the costs would not go down that much. There are no easy answers.

[Karelh]

05:50 PM on 02/25/2012

yup, no easy answers, I'm curious, how would you envision the the process working as a not fee for service? That seems to be a very interesting idea.

[johntoinvent]

05:53 PM on 02/23/2012

Control the Lawyers that sue doctors, then the money spent on 'unnecessary testing' will go down.

[jcaunter]

09:42 PM on 02/23/2012

No it won't. Everyone is getting rich off this racket. The lawyers are only an incidental link in this wealth-stealing chain that's impoverishing the American people.

[boxjelly]

02:05 PM on 02/24/2012

Wrong.

[doctor pangloss]

11:59 PM on 02/23/2012

Without recourse to legal action a patient has no way of getting compensation from the damage done to him by a incompetent quack.

[jimme]

05:29 PM on 02/23/2012

Healthcare should not be a for-profit business. Plain and simple.

[ocgame9]

05:31 PM on 02/23/2012

Nothing should be for profit everyone should work for free to save humanity.

[sagefeldemeyer]

11:53 PM on 02/23/2012

Troll Alert: another idiotic, non-sense right-wing comment; keep 'em comin'--you one-note samba.

[Karelh]

10:23 PM on 02/23/2012

The process for providing (paying for) health care should not be profit based, but the providers of the service should have right to make a profit.

[ur2nutty4me]

05:49 PM on 02/24/2012

Wrong...It should be all non profit with very fare salaries and benefits. It absorbs to much of every countries economies stifling growth and job creation. Everyone deserves health care without barriers and jumping through hoops. Anything else just shows greed and how little we have grown as a species. The Monopoly game of winner take all and at any expense needs to be stopped especially in health-care. It really is a no brain-er for any living thinking caring individual and is just the natural progression of a functioning healthy civilized society. If done health-care employment will grow dramatically.

[smoker]

05:28 PM on 02/23/2012

Some facts for those who are interested:

http://www.reuters.com/article/2010/06/23/us-usa-healthcare-last-idUSTRE65M0SU20100623

http://www.reuters.com/article/2011/11/23/us-usa-healthcare-oecd-idUSTRE7AM0NN20111123

It's also a reality check for those here spouting rhetoric.

[oftenon]

05:22 PM on 02/23/2012

Physician feedlot mentality. Reprehensible, commonplace grifters.

[jimme]

05:21 PM on 02/23/2012

I had an MRI to help find out a problem I was having, it turned out I have MS. I needed another later to help confirm the findings. Both times they were billed at $1000.00. A few years later, my neurologist called for another MRI. Why I don't fully know. But anyways, it was billed at $5000.00.
It was 3 years between and it went up $4000.00. How and why is that possible ?
Are doctor's getting kick-backs from this kind of stuff ?

[Anne Rutherford]

05:45 PM on 02/23/2012

The MRI after another few years of your diagnosis was to determine if your MS was prgoressing. Husband is being treated with Tysabri - and he has to get one yearly to make sure the treatment is still working. Can't begin to say why the price went up as much as it did. Yes, some docs do have interest in testing facilities and will refer patients to the facility that they hold an interest in.

[rmonroe]

11:12 AM on 02/24/2012

It went up because you and your husband have no choice. They have your husbands life in their hands and feel they can charge whatever they please. Greed is rampant in the healthcare profession and it is only getting worse. No longer do they do it for the good of man, they do it for the mighty dollar.

[jimme]

01:34 PM on 02/24/2012

Try I was helped by my wifes insurance. Is Jim suddenly a female name ?

[jimme]

01:38 PM on 02/24/2012

If that's supposed to be a sly gay marriage joke, E S A D. Happily married for 24 years with 4 boys. I'm even a grampa now with 2 granddaughters. WooHoo !

[Red Russet]

05:06 PM on 02/23/2012

If we allow physicians to pass on testing for various conditions, we will wind up with healthcare as bad as Britians. Check out how many die every year from things that should have been treated and were not. If you have any money and live in Britain you always buy yourself a better health insurance policy to bypass or augment the state medical care, which in a lot cases, stinks.

[Anne Rutherford]

05:16 PM on 02/23/2012

And much the same is true here - if you have private insurance you get more care than if you have Medicaid. That being said, in Britian everyone gets routine care. What they don't do in Britian is extend life if you are terminal or do agressive treatment depending on age and other health conditions.

[lakabux]

05:27 PM on 02/23/2012

Most insurance companies would pull the plug as well.

[lakabux]

05:20 PM on 02/23/2012

United States is ranked 37th of the top 50 countries in quality of healthcare. Great Britain is 18th.

http://masterofhealthadministration.com/wp-content/uploads/2010/03/ushealthquality.jpg

[spriddler]

05:37 PM on 02/24/2012

By who and by what criteria? Cancer survival rates? Nope. Access to specialists and procedures? Nope. Prevalence of state of the art equipment and technique? Nope. For all of those things we are either number 1 or in the top three. We get knocked down in the types of survey you mentioned because we have a substantial uninsured population and very high costs. Neither of things are anything to be proud about and must be addressed. However, if I'm going to get sick there is no where else in the world I want to be.